| Organization Name: | UPPER CUMBERLAND MOBILE IMAGING, LLC |
| NPI Number: | 1073802682 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JESSIE HITCHCOCK (ULTRASONOGRAPHER) |
| Mailing Address: | 291 Lake Ln Cookeville |
| State: | TN US |
| Postal Code: | 385067936 |
| Phone Number: | 9312670901 |
| Fax Number: | |
| NPI Enumeration Date: | 04/04/2011 |
| NPI Last Update Date: | 04/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0208X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology, Mobile |
| Taxonomy Definition: | |